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European Surgery

Erschienen in:

20.01.2025 | review

Dancing with medusae—umbilical and ventral hernia repair in patients with cirrhosis

verfasst von: Rifat Latifi, MD FACS FICS FKCS

Erschienen in: European Surgery | Ausgabe 2/2025

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Summary

Background

Caput medusae, a sign of advanced liver cirrhosis and severe portal hypertension, can present a major surgical challenge when associated with a complicated umbilical or ventral hernia due to large-volume ascites requiring surgery.

Methods

This paper describes the author’s technique of complex abdominal wall reconstruction (CAWR) using biologic mesh and reviews the literature of umbilical and ventral hernia repair in patients with cirrhosis and advanced liver disease.

Conclusion

The presence of caput medusae and large-volume ascites should not deter surgeons from performing hernia repair with mesh. Early elective repair of umbilical or ventral hernias in patients with cirrhosis is recommended, and primary repair without mesh should be avoided.

Vorheriger Artikel Robotic TAPP vs. endoscopic TEP for inguinal hernia repair: a register-based analysis of 129 consecutive robotic operations

O’Hara ET, Oliai A, Patek AJ Jr, Nabseth DC. Management of umbilical hernias associated with hepatic cirrhosis and ascites. Ann Surg. 1975;181(1):85–7. https://doi.org/10.1097/00000658-197501000-00018.CrossRefPubMedPubMedCentral

Carbonell AM, Wolfe LG, DeMaria EJ. Poor outcomes in cirrhosis-associated hernia repair: a nationwide cohort study of 32,033 patients. Hernia. 2005;9(4):353–7. https://doi.org/10.1007/s10029-005-0022-x.CrossRefPubMed

Bronswijk M, Jaekers J, Vanella G, Struyve M, Miserez M, van der Merwe S. Umbilical hernia repair in patients with cirrhosis: who, when and how to treat. Hernia. 2022;26(6):1447–57. https://doi.org/10.1007/s10029-022-02617-7.CrossRefPubMed

Latifi R, Samson DJ, Smiley A, Okumura K, Veillette GR, Wolf DC, Nishida S. Complex abdominal wall reconstruction with biologic mesh for ventral/umbilical hernias in patients with cirrhosis: technique and outcomes. Surg Technol Int. 2023;42:sti42/1674.PubMed

Quintero L, Choi J, Rojas A, Latifi R. Complex abdominal wall reconstruction for management of umbilical hernia in cirrhotic patients with ascites: a video technique demonstration. Cir Esp. 2021;99(6):463–34130815. https://doi.org/10.1016/j.cireng.2020.11.017.CrossRefPubMed

Hassan AM, Salama AF, Hamdy H, Elsebae MM, Abdelaziz AM, Elzayat WA. Outcome of sublay mesh repair in non-complicated umbilical hernia with liver cirrhosis and ascites. Int J Surg. 2014;12(2):181–5. https://doi.org/10.1016/j.ijsu.2013.12.009.CrossRefPubMed

Titel: Dancing with medusae—umbilical and ventral hernia repair in patients with cirrhosis
verfasst von: Rifat Latifi, MD FACS FICS FKCS
Publikationsdatum: 20.01.2025
Verlag: Springer Vienna
Erschienen in: European Surgery / Ausgabe 2/2025
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI: https://doi.org/10.1007/s10353-024-00853-y

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Dancing with medusae—umbilical and ventral hernia repair in patients with cirrhosis

Summary

Background

Methods

Conclusion

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